As Georgia's uninsured rate remains higher than national average, stakeholders discuss policy

According to the latest Census, 1.2 million people under 65 years old in Georgia do not have health insurance. That includes about about 171,000 children.

While Georgia’s uninsured rate has gone down over the past five years, it is still higher than the national average. 

Some stakeholders have asked for policy changes to cut down on the number of uninsured people. That includes those appointed to the Comprehensive Health Coverage Commission. 

The commission is set to hold meetings for a period of two years on the topic of health care access and quality, following legislation passed by the General Assembly this year, and held its second meeting last week. 

• RELATED: Commission chair says there's no 'single silver bullet' to improving Georgia's Medicaid program

A presentation by the State Department of Community Health focused on existing programs, but also highlighted some gaps in who the state agency has been able to reach. 

Estimates based on enrollment and Census data show most uninsured adults in the state are eligible for some kind of coverage. That’s roughly 963,000 uninsured adults that are eligible for a Marketplace plan, and about 240,000 adults who are potentially eligible for either traditional Medicaid coverage or Pathways to Coverage, the state’s Medicaid program with work requirements.

DCH Deputy Commissioner Grant Thomas told the commission that although the agency is spending millions on marketing these programs, they find individual circumstances can be a big barrier. 

“There are always going to be people who do not apply for and enroll in health insurance coverage despite it being offered to them, for whatever reason that may be,” Thomas said.

It is possible the number of uninsured people is less than believed, Thomas was quick to note. Enrollment in the federal Marketplace reached a record high this year with 1.3 million Georgians selecting a plan. 

At the same time, over 40,000 people were left uninsured after losing Medicaid coverage due to procedural errors in the redetermination process that all states participated in this past year. It's unclear how many of those people have been able to find insurance again, though around 30,000 deemed inneligible were transfered to Marketplace or other programs.

Thomas said the agency is working on keeping people informed about coverage options through the new state-based exchange, Georgia Access. 

“When they're doing their assessment and taking in an individual's information, they will make a determination,” Thomas said about the interface. Recommendations change based on an individual's income and eligibility for different programs. “That communication is happening.”

But commission member Dr. John Odom, a general surgeon from South Georgia, implored the group to consider a lack of providers and access to technology as possible barriers, especially in rural counties. 

“My patients don't sit around entering their data into computers because they don't have one,” Odom said of his experience in Effingham County. “This isn't going to work, at least what we discussed today, unless there's boots on the ground.”

When it comes to the Pathways program, commission member and Georgia State University professor Harry Heiman said there's an opportunity to consider other approaches. 

"There are other ways to connect people to jobs other than making it a hurdle for Medicaid," Heiman said.  

He told the group it's important to look at other states and create opportunities for public comment. 

Meanwhile, Georgia Democrats rally around Harris health care promises 

Karen Kinsell is the only doctor in Fort Gaines, a town on Georgia's border with Alabama. She joined Georgia lawmakers from around the state on a virtual press call last week following a call to action from the campaign for Vice President Kamala Harris and her running mate, Tim Walz.

Kinsell said it’s hard to describe how dire the situation can get at small, local facilities like her own. 

“The one closest to us right now literally does not own a computer for patient care,” Kinsell shared. 

When it comes to patients seeking care for chronic diseases or pain management, those without access to a primary care doctor like Kinsell rely on inconsistent care in emergency rooms. In fact, there are 10 Georgia counties without a single physician, and several more with less than five. 

State Rep. Debbie Buckner from Talbot County in West Georgia spoke on the financial struggles faced by hospitals in rural areas, calling for a full expansion of Medicaid, like many of her peers. Georgia is one of 10 states to reject full expansion so far. 

“We need to have people come through those doors that can pay the bill, and that is not the case, always,” Buckner said. 

In Georgia, nine rural hospitals have closed since 2010. About double are at risk of closure, according to independent reports, because of financial struggles. 

U.S. Rep. Sanford Bishop of Middle Georgia said his constituents can’t afford any more closures. 

“We know how much devastation our communities have seen, from the opioid epidemic to the COVID-19 pandemic,” Bishop said. “We know how vital it is to have a robust health care system that works for everyone, not just a few.”

Earlier this year, investments secured by Bishop alongside U.S Sens. Jon Ossoff and Raphael Warnock are now being aimed at reopening the shuttered Southwest Georgia Regional Hospital in Cuthbert. 

Bishop said he is hopeful a Harris-Walz administration pulls through with promises to protect the Affordable Care Act and other subsidized health care, and lower costs for insulin and prescription drugs. 

During a visit to Valdosta in August, Republican Vice Presidential candidate J.D. Vance made a point to recognize that local hospitals “don’t have enough resources,” but blamed the closure of rural hospitals on a weak U.S. border.

“What makes rural hospitals not financially viable?” Vance told reporters. “It’s when you bring in millions of illegal aliens into your country, and you give them free health care paid for by American taxpayers.”

In Georgia, undocumented immigrants are only eligible for Medicaid coverage in the case of medical emergencies and for labor and delivery.